Elevated Plasma C-reactive Protein Related to Iron Overload in Maintenance Hemodialysis Patients with Anemia: A Cross-Sectional Observational Study in Vietnam

Background: Iron overload in MHD patients is associated with many factors, including inflammation. Objectives: We conducted this study to determine the ratio of iron overload and its relationship with elevated plasma C-reactive protein (CRP) concentration in maintenance hemodialysis (MHD) patients with anemia. Methods: A cross-sectional observational study was conducted on 103 MHD patients with anemia. Plasma iron, ferritin, total iron-binding capacity (TIBC), and CRP concentrations were measured in all patients. Transferrin saturation (TSAT) was calculated based on plasma ferritin and TIBC concentrations. Patients with plasma ferritin > 800 ng/mL and/or TSAT > 50% were determined to have iron overload. Results: The proportion of iron overload was 51.5% (53/103 patients). The median CRP concentration in the iron overload group was 3.15 (1.66 - 6.67) mg/L, higher than that of the non-iron overload group [1.5 (0.78 - 3.24) mg/L], P < 0.001. Plasma CRP was an independent factor associated with iron overload (P = 0.003). It was also a valuable predictor for iron overload in MHD patients with anemia (AUC = 0.703; P < 0.001). Conclusions: Plasma CRP was a good predictor of iron overload in maintenance hemodialysis patients with anemia.